Mortality rates in patients with rheumatoid arthritis (RA) have continued to increase over the past 4 decades despite the introduction of biologic therapies. Furthermore, more than one half of patients participating in clinical trials of currently available agents do not exhibit a substantial clinical response; some patients have exhibited an attenuated response to treatment over time. Chronic systemic exposure to inflammatory molecules also results in systemic manifestations in some patients with RA, including cardiovascular, pulmonary, bone-related, hematologic, and cutaneous manifestations.

Patients with RA have varying levels of disease aggressiveness and systemic involvement. Response to treatment and susceptibility to adverse effects of pharmacotherapeutic approaches also vary. Clinicians should be aware of the mechanisms of action, efficacy, and safety data of these therapies in order to implement them into standard clinical practice in the absence of clinical guidelines. Data and consensus on the treatment of systemic manifestations of RA are also lacking. Furthermore, individualized treatment approaches are needed to improve patient outcomes and reduce mortality rates.

This eJournal club will engage RA clinicians in an examination, discussion and assessment of the most recent peer-reviewed, RA literature. Areas of focus will include emerging approaches to improve patient function and quality of life, and to reduce mortality.

The target audience includes physicians and allied health professionals who treat patients with RA.

Objectives

On completion of this educational activity, participants will be able to:

• Compare and contrast the relative efficacy and limitations of current therapies for RA
   
• Evaluate the important findings from clinical trials on the use of novel targeted therapies, including circulating cytokines and costimulatory molecules
   
• Describe the potential consequences of targeting the immune system and the appropriate monitoring processes
   
• Review the systemic effects of chronic inflammation in RA